SENIOR CLERK

at  Montefiore Medical Center

SENIOR ACCOUNTING CLERK

Montefiore Professional Service Department is seeking an Accounts Receivable candidate to join our esteemed team. The individual will have an understanding of the full Revenue Cycle, experience working with all payors including Managed Care, Governmental, and Commercial and be experienced in appealing denied claims.

Responsibilities:

• Reviews and resolves billing edits and claim denials from payors by researching payor policies, reviewing billing records, and understanding EPIC workflows
• Submits corrected claim(s)/appeals in accordance with payor policies and billing regulations to maximize reimbursement and efficiently lower A/R
• Maintain account notes detailing progress on collecting open aged receivables &/or disputes
• Prepares appeal letters to insurance carrier with necessary information to accompany appeal
• Collaborates with team on additional Workflows and/or Job Aids
• Completes all assigned work in a timely manner based on internal, client and/or payer standards
• Identify root causes of denials to Manager in order to enhance the system, work with Contracting on payor issues, or communicate departmental workflow issues to the Engagement Manager
• Communicates with manager any changes, updates, or new policies identified through day-to-day functions

Education and skills required:

• High school diploma required, some college preferred
• At least two (2) years’ experience in a physician billing setting
• Experience in the EPIC PB billing system is required.
• Independent, detail oriented individual with strong analytical skills.
• Must have a good verbal and written communication skills.
• Must have knowledge of health insurance reimbursement and billing requirements.
• Must be familiar with HIPPA guidelines.
• Must be able to apply policy and procedure to make independent decisions to secure reimbursement

Department: Professional Services Bargaining Unit: 1199 Campus: YONKERS Employment Status: Regular Full-Time Address: 3 Executive Boulevard, Yonkers
Shift: Day Scheduled Hours: 7:30 AM-4 PM Req ID: 219009 Salary Range/Pay Rate: $26.84
For positions that have only a rate listed, the displayed rate is the hiring rate but could be subject to change based on shift differential, experience, education or other relevant factors.
To learn more about the “Montefiore Difference” – who we are at Montefiore and all that we have to offer our associates, please click here.

• Reviews and resolves billing edits and claim denials from payors by researching payor policies, reviewing billing records, and understanding EPIC workflows
• Submits corrected claim(s)/appeals in accordance with payor policies and billing regulations to maximize reimbursement and efficiently lower A/R
• Maintain account notes detailing progress on collecting open aged receivables &/or disputes
• Prepares appeal letters to insurance carrier with necessary information to accompany appeal
• Collaborates with team on additional Workflows and/or Job Aids
• Completes all assigned work in a timely manner based on internal, client and/or payer standards
• Identify root causes of denials to Manager in order to enhance the system, work with Contracting on payor issues, or communicate departmental workflow issues to the Engagement Manager
• Communicates with manager any changes, updates, or new policies identified through day-to-day function